System and method for producing medical image data onto portable digital recording media

ABSTRACT

This application discloses a system for recording medical image data for production on a portable digital recording medium such as CDs and DVDs. This system includes a receiving module, a processing module and an output module, with viewing program for viewing medical image data stored on the portable digital recording medium. It also discloses a method of storing medical image data on a portable digital recording medium, including the steps of receiving the medical image data, processing the data and storing the data on the portable digital recording medium, with a viewing program for viewing medical image data stored on the portable digital recording medium. It further discloses a method of selecting medical image data for recording on a portable digital recording medium, including the steps of connecting a browsing terminal to a computer database that stores the medical image data, selecting a first set of the medical image data from the computer database, and recording the selected first set of medical image data on the portable digital medium, with a viewing program for viewing the medical image data stored on the portable digital recording medium. It also discloses the method and system of retrieving medical image data that are related to the received/selected original medical image data, and recording the original and related medical image data on a portable digital recording medium.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.11/942,630, filed on Nov. 19, 2007, which is a continuation of U.S.patent application Ser. No. 09/761,795, filed on Jan. 17, 2001, now U.S.Pat. No. 7,302,164, issued Nov. 27, 2007, and claims priority to U.S.Provisional Patent Application 60/181,985, filed on Feb. 11, 2000. Theentire disclosure of these priority applications are hereby incorporatedby reference herein in their entirety.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates to a system and method for the production ofmedical image data on portable digital recording media such as compactdiscs. More particularly, it relates to a system and method forreceiving medical image data, processing medical image data, andtransmitting medical image data to be recorded on a portable digitalrecording medium.

2. Description of the Related Art

Since the invention of the x-ray film, film has been the predominantmultipurpose medium for the acquisition, storage, and distribution ofmedical images. However, the storage and distribution of film oftenrequires considerable expenses in labor and storage space.

Today's modern hospitals utilize computer-aided imaging devices such asComputed Tomography (CT), Digital Subtracted Angiography, and MagneticResonance Imaging (MRI). These digital devices can generate hundreds ofimages in a matter of seconds. Many hospitals require these images to beprinted on film for storage and distribution. To print complete sets ofmedical images from these digital devices, the cost in film material,storage space, and management efforts is often very high.

Some radiology departments have installed digital image storage andmanagement systems known as PACS (Picture Archive CommunicationSystems). PACS are capable of storing a large amount of medical imagedata in digital form. PACS are made by manufacturers including GE,Siemens, and Fuji.

To ease the communication of data, the DICOM (Digital Imaging andCommunications in Medicine) standard was developed by ACR-NEMA (AmericanCollege of Radiology-National Electrical Manufacturer's Association) forcommunication between medical imaging devices and PACS. In addition tothe examined images, patient demographics, and exam information such aspatient name, patient age, exam number, exam modality, exam machinename, and exam date can also be stored and retrieved in DICOM compatibledata format. A DICOM file stores patient and exam information in theheader of the file, followed by the exam images. PACS store medicalimage data in DICOM format.

Digital medical image data can be stored on PACS and distributed usingthe Internet. However, many physicians' offices do not have thebandwidth suitable for fast download of medical image data. The concernsfor medical data privacy and Internet security further reduce thedesirability of Internet distribution.

SUMMARY OF THE INVENTION

The claimed system allows for digital medical image data to be producedon a portable digital recording medium such as a CD. A CD containing themedical image data can be distributed to physicians, hospitals,patients, insurance companies, etc. One embodiment of the claimed systemallows for medical image data to be placed on a CD along with a viewingprogram, so that a user can use any computer compatible with the CD toview the medical image data on the CD. One embodiment of the claimedsystem allows for searching medical exam data that are related andplacing such data on the same CD.

One embodiment of the claimed system comprises a receiving moduleconfigured to receive medical image data, a processing module configuredto process the received medical image data, and an output moduleconfigured to transmit the processed medical image data to a productionstation configured to produce the transmitted medical image data onportable digital recording medium, such as a CD. In one embodiment, theoutput module transmits a viewing program configured to view medicalimage data to the production station so that the viewing program isproduced on the same CD as the medical image data. In anotherembodiment, the CD already contains the viewing program before themedical image data is transmitted to the CD production station.

In one embodiment of the claimed system, the processing module isconfigured to create and store audit information of the portable digitalrecording medium produced by the production station.

In another embodiment of the claimed system, the processing module isconfigured to identify the originating image input device of thereceived medical image data, and determine, on the basis of theoriginating image input device, whether to transmit the received medicalimage data to a production station. The processing module also selects,on the basis of the originating image input device, one of multipleproduction stations as the target production station.

Yet another embodiment of the claimed system is configured to retrievemedical image data that are related to the received medical image data,and transmit the retrieved related image data to the production station.In one embodiment, exam images of the same patient are consideredrelated. In another embodiment, exam images of the same patient and thesame modality are considered related. For example, two x-ray exams onthe left hand of the same patient are considered related. In yet anotherembodiment, exam images of the same patient, the same modality and takenwithin a specified date range are considered related. For example, twox-ray exams on the left hand of the same patient taken within atwo-month period are considered related. A hospital may also determineother scenarios of relatedness.

One claimed method comprises the steps of connecting a browsing terminalto a computer database configured to store medical image data, selectingmedical image data from medical image data stored on the database, andrecording the selected medical image data on portable digital recordingmedium. In one embodiment, the claimed method also comprises a step ofrecording a viewing program configured to view medical image data on theportable digital recording medium.

One embodiment of the claimed method further comprises the steps offinding and retrieving medical image data that are related to theselected medical image data, and recording related image data toportable digital recording medium.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates one embodiment of an image production systemcomprising an application server and portable digital recording mediumproduction stations.

FIG. 2 illustrates sample records of one embodiment of an image inputdevice profile table.

FIG. 3 illustrates a process of receiving image data from image server,processing received image data, and transmitting such data to theproduction station. This process also retrieves and transmits relatedimage data for production.

FIG. 4 illustrates a process of a user selecting and ordering theproduction of image data stored on the application server.

FIG. 5 illustrates a process of a user selecting and ordering theproduction of image data stored on the application server, with theoption of selecting and ordering the production of related image data.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

FIG. 1 illustrates one embodiment of an image production system 100comprising an application server 110 and one or more portable digitalrecording medium production stations 300A, 300B and 300C. In thepreferred embodiment, the production stations 300A, 300B and 300C are CD(Compact Disc) production stations. Digital portable recording mediumcomprises CDs and DVDs (Digital Versatile Disc or Digital Video Disc).CDs may comprise CD-ROM (Compact Disc Read Only Memory), CD-R (CompactDisc Recordable), and CD-RW (Compact Disc Recordable and Writable). DVDsmay comprise DVD-ROM (DVD Read Only Memory), DVD-R (DVD Recordable) andDVD-RAM (a standard for DVDs that can be read and written many times).Thus, although the following description refers primarily to CDs, thoseof ordinary skill in the art will understand that any suitable portabledigital recording medium can be substituted for CDs.

The application server 110 is connected to one or more physicianbrowsing terminals 400A, 400B and 400C through a computer network 600.Each physician browsing terminal 400A, 400B or 400C comprises a browsingprogram such as Internet Explorer or Netscape Communicator. Physiciansor their assistants launch the browsing program to access theapplication server 110 through the network 600 in order to selectmedical image data stored on the application server database 114 to beproduced by a production station 300A, 300B or 300C. In the preferredembodiment, the physician browsing terminals 400A, 400B and 400C areconnected to the application server through an Intranet. One embodimentof the Intranet utilizes TCP/IP network protocol. The Intranet canconnect one radiology department, multiple departments within ahospital, or multiple hospitals. In another embodiment the browsingterminals 400A, 400B and 400C are connected to the application server110 through the Internet.

Still referring to FIG. 1, the application server 110 is also connectedto an image server 200. The image server 200 is further connected toimage input devices such as PACS 204, MRI machines 206, CT-scan machines208, ultrasound machines 210, etc. In the preferred embodiment, theimage server 200 is a DICOM image server configured to receive and storemedical image data in DICOM format. In operation, the image server 200receives medical image data from image input devices such as PACS 204,MRI machines 206, CT-scan machines 208 and ultrasound machines 210 andstores such image data in the image server database 202. Ahigh-resolution image scanner 500 is also connected to the image server200, so that medical image data stored on film can be scanned on theimage scanner 500, transmitted to the image server 200 and stored in theimage server database 202. In one embodiment, the image scanner 500 alsoconverts the scanned image to DICOM format. The application server 110receives input image data from the image server database 202, processesthe received image data, and sends the image data to one of theproduction stations 300A, 300B or 300C to produce CDs.

The application server 110 comprises a viewing program 112, anapplication server database 114 that stores image data received from theimage server 200, a production history database 116 that stores auditrecords on each CD produced, a display terminal 118 for programming andoperating the application server 110 by a programmer or physician, andan image input device profile table 120.

Still referring to FIG. 1, the viewing program 112 is configured toallow users to read and manipulate medical image data. The viewingprogram 112 comprises multiple image manipulation functions, such asrotating images, zooming in and zooming out, measuring the distancebetween two points, etc. The viewing program 112 also allows users toread the patient demographics and exam information associated with theimage data. The viewing program 112 used in the preferred embodiment isproduced by eFilm Medical Inc. located in Toronto, Canada. The viewingprogram 112 used in the preferred embodiment is an abbreviated versionwith fewer functions and takes less storage space, in order to maximizethe storage space for image data on a CD. The image server 200 used inthe preferred embodiment is also made by eFilm Medical Inc.

The CD production stations 300A, 300B and 300C in the preferredembodiment are produced by Rimage Corporation in Edina, Minn. Detailsabout the Rimage CD production stations can be found in U.S. Pat. Nos.5,542,768, 5,734,629, 5,914,918, 5,946,276, and 6,041,703, which areincorporated herein by reference in their entirety.

The application server 110 in the preferred embodiment runs on apersonal computer running a 400 MHz Celeron or Pentium II/III chip, withWindows 98 or NT as the operating system.

FIG. 2 illustrates sample records of one embodiment of an image inputdevice profile table 120. The image input device profile table 120contains a profile record for each image input device. Each image inputdevice's profile record comprises: (1) an “auto-produce” logical field250 indicating whether medical image data from this image input deviceshould be produced on CD automatically by the image production system100, (2) a “target production station” field 252 identifying one of theproduction stations 300A, 300B or 300C on which medical image data is tobe produced, and (3) a “related data storage” 254 field identifying themedical image data storage units in which to search for the relatedimage data. A medical image data storage unit is a storage unit thatstores medical image data and is connected to the application server110. In one embodiment, a medical image data storage unit is connectedto the application server 110 through the image server 200. In thepreferred embodiment, PACS 204 is such a medical image data storageunit.

In FIG. 2, the sample profile table 120 contains profile records for MRIMachine I, MRI Machine II, and Ultrasound Machine I. For MRI Machine I,the “auto-produce”field 250 contains a “yes” value, directing the imageproduction system 100 to automatically produce image data originatingfrom MRI Machine I on portable digital recording medium. Its “targetproduction station” field 252 contains a “Production Station A” value,directing the image production system 100 to produce image dataoriginating from MRI Machine I on production station A. Its “relateddata storage” field 254 is “PACS I”, directing the image productionsystem 100 to retrieve related medical image data from PACS I. For MRIMachine II, the “auto-produce” field 250 is “no”, directing the imageproduction system 100 to not automatically produce image dataoriginating from MRI Machine II on portable digital recording medium.Since image data from MRI Machine II will not be automatically produced,the “target production station” field 252 and the “related data storage”field 254 are irrelevant. For Ultrasound Machine I, the “auto-produce”field 250 is “yes”, and its “target production” filed 252 is “ProductionStation B”. Its “related data storage” field 254 contains a value of“PACS I, PACS II”, directing the image production system 100 to searchPACS I and PACS II for related medical image data.

FIG. 3 illustrates a process of the application server 110 receivingimage data from the image server 200, processing the received imagedata, and transmitting such data to the production station 300A, 300B or300C. The application server 110 continuously monitors the image serverdatabase 202 in step 122. In one embodiment, the application servercontinuously “pings” the network address corresponding to the imageserver 200 on the network that connects the application server 110 withthe image server 200.

Still referring to FIG. 3, the application server 110 determines if theimage server database 202 is changing, in step 124. In the preferredembodiment, the application server 110 makes that determination bydetecting whether the image server database 202 is increasing in size.If there is no change in the image server database 202, then theapplication server 110 returns to step 122 to continue monitoring. Ifthere is change in the image server database 202, then the applicationserver 110 proceeds to step 126 and time-stamps the moment that thechange started. The application server 110 then proceeds to step 128 andwaits for an interval, typically 35 to 65 seconds. After the interval,the application server 110 checks whether the image server database 202is still changing, in step 130. If the image server database 202 isstill changing then the application server 110 returns to step 128 towait for another interval. If the image server database 202 is no longerchanging, then the application server 110 proceeds to step 132 andcopies the data changed since the time-stamped moment. This changed datais copied from the image server database 202 to the application serverdatabase 114.

The application server 110 proceeds to step 134 and finds the inputimage device name or identification number from the newly received imagedata. In the preferred embodiment, image data from the image serverdatabase 202 are stored in DICOM format, and the input image device nameor identification number is stored in the header of the DICOM formatimage data file. The input image device name/ID indicates the origin ofthe newly received data. The application server 110 proceeds to step 136and uses the found input image device name/ID to find a correspondingprofile record in the image input device profile table 120. If theprofile record has an “auto-produce” field 250 with a “no” value, theapplication server 110 returns from step 138 to step 122 to continuemonitoring the image server database 202. If the “auto-produce” field250 contains a “yes” value, the application server 110 proceeds fromstep 138 to step 140, and determines the target production station 300A,300B or 300C from the “target production station” field 252 of theprofile record. In step 140, the application server 110 also determinesthe value in the “related data storage” field 254 of the profile record.

Still referring to FIG. 3, in step 142, the application server 110 sendsa copy of the newly received data, along with a copy of the viewingprogram 112, to the target production station 300A, 300B or 300Cidentified in step 140. With the viewing program attached, the imagedata on each CD produced by the target production station 300A, 300B or300C can be viewed on any computer that accepts the CD, regardless ofwhether that computer has its own viewing program installed. In oneembodiment, the data received in step 132 is stored in the applicationserver database 114 before it is transmitted to the target productionstation 300A, 300B or 300C in step 142. In another embodiment, theapplication server 110 transmits the data received in step 132 to thetarget production station 300A, 300B or 300C, without storing a copy ofthe data in the application server database 114.

In one embodiment, the application server 110 does not send a copy ofthe viewing program 112 to the target production station during step142. Rather, the application server 110 sends a copy of the receivedmedical image data to the production station 300A, 300B or 300C to berecorded on pre-burned CDs. Each pre-burned CD contains a viewingprogram already recorded onto the CD before step 142.

In step 142, the application server 110 also sends configuration data tothe target production station 300A, 300B or 300C. The configuration datacomprises a label-printing file comprising the specification forprinting labels on top of the CDs, and a “number of copies” valueindicating the number of copies of CDs to be produced. A typicalspecification in the label-printing file may specify information such aspatient name, exam modality, hospital name, physician name, productiondate, etc. to be printed by the target production station as a label onthe top of each CD produced.

Still referring to FIG. 3, in step 143, the application server 110searches the application server database 114 for image data related tothe newly received data. The application server 110 then searches thePACS systems identified in the “related data storage” field 254 in step140 for data related to the newly received data. Some PACS systems eachcomprise a primary image data storage and an archive image data storage,and the application server 110 searches both the primary image datastorage and the archive image data storage on these PACS systems. Theapplication server 110 is connected to the PACS systems through theimage server 200. The application server 110 retrieves found relateddata from the PACS systems and stores a copy of such found related datain the application server database 114. The application server 110 sendsa copy of related data that are found from the application serverdatabase 114 or the PACS systems to the target production station 300A,300B or 300C. The medical image data originally received in step 132 andthe related medical image data are produced by the target productionstation 300A, 300B or 300C on the same CDs for comparative study.

For each CD to be produced, the application server 110 adds one auditrecord to the production history database 116 in step 144. The new auditrecord comprises the identification number of the CD and other relevantinformation about the CD, such as the physician who requested theproduction (if any), and the names of the patients whose exam images areon that CD.

Steps 142, 143 and 144 may be executed immediately before, concurrentwith, or immediately after one another.

The target production station 300A, 300B or 300C produces the CDscontaining the medical image data and the viewing program sent to it,and prints a label on top of every CD, corresponding to thespecification in the label-printing file. The number of CDs producedcorresponds to the “number of copies” number sent by the applicationserver 110 in step 142. When the target production station has producedthe CDs, the production station returns a “completed” signal to theapplication server 110. The application server 110 waits for this signalin step 146.

Still referring to FIG. 3, in step 148, the application server 110updates the audit records in the production history database 116 thatwere created in step 144. For each CD produced, the application 110server updates the date and time of production for that CD's auditrecord. The application server 110 also updates the status value forthat CD's audit storage record from “processing” to “successful”. Theapplication server 110 then continues monitoring the image serverdatabase 202 as in step 122.

FIG. 4 illustrates a process of a user selecting and ordering theproduction of image data stored on the application server 110. A user,typically a physician or physician's assistant, accesses the applicationserver database 114 from a browsing terminal 400A, 400B or 400Cconnected to a network 600. In one embodiment, the user launches abrowser such as Microsoft Internet Explorer or Netscape Communicator,and specifies a network address corresponding to the application server110, in step 150. In another embodiment, the user clicks a pre-definedicon that directly launches a browser connecting to the applicationserver 110. The application server 110 prompts the user to enter apassword or an identification name coupled with a password, in step 152.The application server 110 checks if the entered identification/passwordis authorized in step 154. If the entered identification/password is notauthorized the user is returned to step 152 to re-enter theidentification/password, or disconnected from the application server110. If the entered identification/password is authorized then the useris allowed access to the application server database 114 and theapplication server 110 proceeds to step 156.

Still referring to FIG. 4, in step 156 the user is prompted to select apatient from a list of patients with exam images in the applicationserver database 114. The user is then shown a list of the selectedpatient's exams, and is prompted to select one or more exams of thatpatient, in step 158. When the user indicates that he/she has completedselecting all exams for that patient, the user is asked in step 160whether to select another patient from the list of patients. If the useranswers “yes”, the user is returned to step 156 to select anotherpatient. If the user answers “no”, the user proceeds to step 162.

In another embodiment, when a user selects a patient, all examsbelonging to that patient will be automatically selected withoutprompting for user selection. In yet another embodiment, the user is notprompted to select patients, but is only prompted to select exams from alist of all exams for all patients contained in the application serverdatabase 114.

When the user indicates that he/she has completed selecting, the user isprompted to select a production station from a list of productionstations 300A, 300B and 300C in step 162. The user is also prompted toenter additional label text to be printed as labels on the CDs to beproduced, to supplement the text printed according to the specificationof the label-printing file. The user can advantageously select theproduction station located closest to his/her office. In one embodiment,only one production station is connected to the application server 110,and the lone production station will be the selected production stationwithout prompting for user selection.

In one embodiment, the user is also prompted to select the number ofcopies of CDs to be produced. In another embodiment, the number ofcopies is set at one without prompting for user direction. As describedabove in connection with FIG. 3, in step 164, the application server 110sends a copy of the image data of the selected exams for the selectedpatients to the selected production station, along with a copy of theviewing program 112, and configuration data comprising a label-printingfile, additional label text, and a number indicating the number ofcopies of CDs to be produced. The production station 300A, 300B or 300Cthen produces one or more CDs containing the selected exams for theselected patients and the viewing program, with labels printed on top ofthe CDs according to the specification in the label-printing file andthe user-entered additional label text.

In another embodiment, a user accesses the application server database114 not from a browsing terminal 400A, 400B or 400C, but directly fromthe display terminal 118. In this embodiment the user directly proceedsfrom step 152. In this embodiment the user is typically a programmer oroperator of the image production system 100.

FIG. 5 illustrates a process of a user selecting and ordering theproduction of image data stored on the application server 110, with theadditional option of selecting and ordering the production of relateddata for comparative study. As described above in connection with FIG.4, a user connects to the application server 110 from a browsingterminal 400A, 400B or 400C in step 170. The user enters identificationinformation and a password in step 172. Step 174 determines whether theuser is authorized to access the application server database 114. Ifauthorized, the user is prompted to select a patient in step 176, andselects exams of the selected patient in step 178. The user is thenasked in step 180 if he/she desires to find related data of that patientfor comparative study.

If the user answers yes, the application server 110 then searches forrelated data. The application server 110 finds the image input deviceprofile table 120 profile record corresponding to the image input devicefrom which the selected data originates, identifies the list of PACSsystems stored in the “related data storage” field 254, and searchesthese PACS systems for related data. In another embodiment, once theuser has selected a patient/exam combination, the application server 110automatically searches for related data without asking for userdirection. In this embodiment, the application server 110 alerts theuser if related data are found. In one embodiment, the applicationserver 110 also searches the application server database 114 for relatedmedial image data.

Still referring to FIG. 5, the user is then prompted to select all orsome of the related data from the list of found related data forproduction, in step 184. In another embodiment, all found related dataare automatically selected by the application server 110 for production,without prompting for user selection.

The user is then prompted to select another patient in step 186. Afterthe user has completed selecting all patients, the user is prompted toselect a CD production station 300A, 300B or 300C in step 188. The useris also prompted to enter additional label text. In step 190, theapplication server 110 then sends a copy of the original and selectedrelated data, along with a copy of the viewing program 112, a numberindicating the number of copies to be produced, additional label text,and a label-printing file to the selected production station 300A, 300Bor 300C for production.

The above paragraphs describe the application server 110 with onedatabase 114 for image data storage. In another embodiment, theapplication server 110 includes two databases for image data storage: anew data database and a storage data database. The new data databasestores only the most recent batch of new data just received from theimage server 200. After the data in the new data database is sent to aproduction station 300A, 300B or 300C, the application server 110 erasesdata in the new data database. The storage data database stores all datathat has ever been received from the image server database 202. In theprocesses described by FIG. 4 and FIG. 5, a user selects images forproduction from the storage data database.

Several modules are described in the specification and the claims. Themodules may advantageously be configured to reside on an addressablestorage medium and configured to execute on one or more processors. Themodules may include, but are not limited to, software or hardwarecomponents that perform certain tasks. Thus, a module may include, forexample, object-oriented software components, class components,processes methods, functions, attributes, procedures, subroutines,segments of program code, drivers, firmware, microcode, circuitry, data,databases, data structures, tables, arrays, and variables. Modules maybe integrated into a smaller number of modules. One module may also beseparated into multiple modules.

Although the foregoing has been a description and illustration ofspecific embodiments of the invention, various modifications and changescan be made thereto by persons skilled in the art, without departingfrom the scope and spirit of the invention as defined by the followingclaims.

1. A system for generating a computer-readable medium containing medicaldata related to a user based on a remote search request received from abrowsing station, said system comprising: multiple remote productionstations each configured to generate a computer-readable mediumcontaining medical data, said remote production stations being separatefrom the browsing station and each said remote production station beingcoupled to an application server; a computer database containing medicaldata related to users; and an application server unit configured to:receive a search request for medical data related to the user; retrievethe requested set of medical data from the computer database based onthe search request; and cause the generation of the computer-readablemedium at a particular remote production station containing therequested set of medical data, wherein the particular remote productionstations is chosen from among the multiple remote production stations.2. The system of claim 1, wherein the particular remote productionstation is chosen from among the multiple remote production stationsbased on the search request.
 3. The system of claim 1, wherein theparticular remote production station is chosen from among the multipleremote production stations based on requester selection.
 4. The systemof claim 1, wherein the browsing station is remote from the applicationserver.
 5. The system of claim 1, wherein the computer database is alocal computer database and the application server unit is furtherconfigured to: send a second search request to a remote server connectedto a second database, said search request requesting additional medicaldata related to the user; and receive, from the remote server, anadditional set of medical data related to the user; and whereingenerating the computer-readable medium comprises generating acomputer-readable medium containing both the requested set of medicaldata related to the user and the additional set of medical data relatedto the user at the particular remote production station.
 6. The systemof claim 5, wherein sending a second search request to the remote servercomprises determining metadata related to the requested set of medicaldata and determining the second search request based on the metadata. 7.A method for generating at a production station a computer-readablemedium containing medical data related to a user, based on a remotesearch request from a browsing terminal, said production station beingchosen from among multiple remote production stations each configured togenerate a computer-readable medium containing medical data, each remoteproduction station being separate from the browsing terminal, saidmethod comprising: receiving a search request for medical data relatedto the user at an application server coupled to each remote productionstation; retrieving the requested set of medical data at the applicationserver from a computer database based on the search request; andgenerating the computer-readable medium at particular remote productionstation from among multiple remote production stations, saidcomputer-readable medium comprising the requested set of medical data.8. The method of claim 7, wherein the particular remote productionstation is chosen from among the multiple remote production stationsbased on the search request.
 9. The method of claim 7, wherein theparticular remote production station is chosen from among the multipleremote production stations based on requester selection.
 10. The methodof claim 7, wherein the browsing station is remote from the applicationserver.
 11. The method of claim 7, wherein the computer database is alocal computer database and the method further comprises: sending asecond search request to a remote server connected to a second database,said search request requesting additional medical data related to theuser; and receiving, from the remote server, an additional set ofmedical data related to the user; and wherein generating thecomputer-readable medium comprises generating a computer-readable mediumcontaining both the requested set of medical data related to the userand the additional set of medical data related to the user at theparticular remote production station.
 12. The method of claim 11,wherein sending a second search request to the remote server comprisesdetermining metadata related to the requested set of medical data anddetermining the second search request based on the metadata.